Gastric intramural pH as indicator of early allograft viability in orthotopic liver transplantation.

The determination of the viability of OLT grafts has relied upon metabolic tests of the liver, which the several hours to evaluate and therefore are only conclusive in most patients well into the postoperative period. Earlier diagnosis of graft failure or nonfunction would allow intraoperative ressessment of surgical technique and, in the case of grft failure, earlier planning for retransplantation. Since gastrointestinal mucosal ischemia is one of the earliest manifestations of impaired core tissue in the critically ill, a tonometric nasogastric tube Tonomitor) was used in our patients to measure intramucosal gastric PH (pHi) during the preanhepatic (stage I), anhepatic (stageII), and neohepatic (stage III) phases of OLT in 35 patients as an indicator of graft liver function and viability